Ankle Splints Improve Mobility Following a Stroke HCC

A new review of studies has shown that ankle and foot orthotic splints can help patients that have suffered a stroke regain the ability to walk and retain their balance.

Researchers at the University of Salford (Manchester, UK) analyzed 14 clinical studies involving 429 participants that examined possible improvement following orthotics in walking speed, balance, and stride length; they also assessed foot drop during the swing phase of walking. The researchers only included studies that examined immediate effects of splints, rather than long-term impact. The results of these studies showed that ankle and foot orthotic splints could help stroke patients regain their ability to walk and maintain balance, but offered less improvement for other activities, such climbing stairs. The review also uncovered, surprisingly, that using wrist splints did not lead to signs of improvement in the hands or the arms; in fact, wrist splints had no effect on the ability to use the arm, with no change in range of movement at the wrist, fingers or thumbs, or in accompanying pain. The review was published in the January 2009 issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international nonprofit, independent organization that produces and disseminates systematic reviews of health care interventions, and promotes the search for evidence in the form of clinical trials and other studies of interventions.


"This result was also surprising as the use of orthotics to prevent contractures (loss of range of movement) is thought to be very important in restoring use of the arm after stroke,” said coauthor Sarah Tyson, Ph.D., a senior research fellow with the center for rehabilitation and human performance research at Salford. "These results throw that belief into doubt; however, the results are based on a very small number of studies, so we need to do larger trials and look at the use of orthotics combined with other established treatments, such as physiotherapy or botulinum toxin.”

Orthotic splints are made of plastic or metal; clinicians usually custom-mold ankle foot splints to the lower leg and then adjust them to help compensate for the patient's specific deficit. For the most part, the splints start around the ball of the foot and extend upwards to a few inches below the knee. Arm and hand splints most often include the palm to an inch or so above the wrist. Initially, these braces are used to increase the range of motion in fingers and hands that may have been frozen into a fist or have muscles that are hard to control following a stroke. This is intended to help the patient regain use of their upper extremities to eat, write, or pick things up more efficiently.

Related Links:
University of Salford
The Cochrane Collaboration